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Article ; Online: Autonomic Nerve Involvement in Post-Acute Sequelae of SARS-CoV-2 Syndrome (PASC)

Tae Hwan Chung / Antoine Azar

Journal of Clinical Medicine, Vol 12, Iss 1, p

2022 Volume 73

Abstract: The novel SARS-CoV-2 virus and resulting COVID-19 global pandemic emerged in 2019 and continues into 2022. While mortality from COVID-19 is slowly declining, a subset of patients have developed chronic, debilitating symptoms following complete recovery ... ...

Abstract	The novel SARS-CoV-2 virus and resulting COVID-19 global pandemic emerged in 2019 and continues into 2022. While mortality from COVID-19 is slowly declining, a subset of patients have developed chronic, debilitating symptoms following complete recovery from acute infection with COVID-19. Termed as post-acute sequelae of SARS-CoV-2 syndrome (PASC), the underlying pathophysiology of PASC is still not well understood. Given the similarity between the clinical phenotypes of PASC and postural orthostatic tachycardia syndrome (POTS), it has been postulated that dysautonomia may play a role in the pathophysiology of PASC. However, there have been only a few studies that have examined autonomic function in PASC. In this retrospective study, we performed an analysis of autonomic nerve function testing in PASC patients and compared the results with those of POTS patients and healthy controls. Our results suggest that a significant number of PASC patients have abnormal autonomic function tests, and their clinical features are indistinguishable from POTS.
Keywords	post-acute sequelae of SARS-CoV-2 syndrome (PASC) ; long COVID ; post-COVID syndrome ; postural orthostatic tachycardia syndrome (POTS) ; dysautonomia ; autonomic nerve ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Innovation in Cardiology, Lebanon.

Azar, Rabih / Sarkis, Antoine

European heart journal

2019 Volume 40, Issue 2, Page(s) 83–84

Language	English
Publishing date	2019-01-03
Publishing country	England
Document type	Journal Article
ZDB-ID	603098-1
ISSN	1522-9645 ; 0195-668X
ISSN (online)	1522-9645
ISSN	0195-668X
DOI	10.1093/eurheartj/ehy819
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Article ; Online: Antibody response to COVID-19 booster vaccine in rituximab-treated patients with anti-neutrophil cytoplasmic antibody-associated vasculitis.

Kant, Sam / Azar, Antoine / Geetha, Duvuru

Kidney international

2021 Volume 101, Issue 2, Page(s) 414–415

MeSH term(s)	Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy ; Antibodies, Antineutrophil Cytoplasmic ; Antibody Formation ; COVID-19 ; COVID-19 Vaccines ; Humans ; Remission Induction ; Rituximab/adverse effects ; SARS-CoV-2
Chemical Substances	Antibodies, Antineutrophil Cytoplasmic ; COVID-19 Vaccines ; Rituximab (4F4X42SYQ6)
Language	English
Publishing date	2021-11-22
Publishing country	United States
Document type	Letter
ZDB-ID	120573-0
ISSN	1523-1755 ; 0085-2538
ISSN (online)	1523-1755
ISSN	0085-2538
DOI	10.1016/j.kint.2021.11.012
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Article ; Online: Bilateral ectopic third molar in the maxillary sinuses associated with dentigerous cyst: a case report.

Berberi, Antoine / Aoun, Georges / Hjeij, Bouchra / AboulHosn, Maissa / Al Assaad, Hiba / Azar, Elie

Medicine and pharmacy reports

2023 Volume 96, Issue 2, Page(s) 221–224

Abstract: A dentigerous cyst is an epithelial-lined odontogenic cyst formed by an accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla and the ... ...

Abstract	A dentigerous cyst is an epithelial-lined odontogenic cyst formed by an accumulation of fluid between the reduced enamel epithelium and the crown of an unerupted tooth. About 70% of dentigerous cysts occur in the mandible and 30% in the maxilla and the most involved teeth are maxillary canines and maxillary third molars. Dentigerous cysts often displace the related tooth into an ectopic position. In the maxilla, when the cyst expands into the sinus, it usually causes total or partial occupation of the sinus cavity and can extend to the nose. We report a rare case of a 24-year-old woman with bilateral maxillary third molars inside the maxillary sinuses attached to a dentigerous cyst and treated with a minimally invasive endoscopic surgery through the middle meatal meatotomy.
Language	English
Publishing date	2023-04-27
Publishing country	Romania
Document type	Case Reports
ZDB-ID	2974425-8
ISSN	2668-0572 ; 2602-0807
ISSN (online)	2668-0572
ISSN	2602-0807
DOI	10.15386/mpr-2072
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Article ; Online: Global impact of the new European and American hypertension guidelines: A perspective from Lebanon.

Azar, Rabih R / Sarkis, Antoine

Journal of clinical hypertension (Greenwich, Conn.)

2019 Volume 21, Issue 5, Page(s) 684–686

MeSH term(s)	Adult ; Aged ; Antihypertensive Agents/therapeutic use ; Awareness ; Drug Therapy, Combination ; Europe/epidemiology ; Global Health/standards ; Guidelines as Topic ; Humans ; Hypertension/diagnosis ; Hypertension/drug therapy ; Hypertension/epidemiology ; Hypertension/physiopathology ; Lebanon/epidemiology ; Middle Aged ; Prevalence ; United States/epidemiology
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2019-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2077222-1
ISSN	1751-7176 ; 1524-6175
ISSN (online)	1751-7176
ISSN	1524-6175
DOI	10.1111/jch.13526
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Article ; Online: Randomized double-blind pilot study of universal, species abundant, multiallergen subcutaneous immunotherapy for moderate-severe allergic rhinitis.

Tversky, Jody / Patel, Pooja / Sowho, Mudiaga / Natarajan, Rakesh / Chung, Tae / Whelton, Andrew / Azar, Antoine

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology

2023 Volume 131, Issue 1, Page(s) 89–95

Abstract: Background: Allergic rhinitis affects approximately 10% to 20% of people living in industrialized nations leading to significant morbidity and large health care expenditures. Individualized high-dose, single-species allergen immunotherapy has been found ...

Abstract	Background: Allergic rhinitis affects approximately 10% to 20% of people living in industrialized nations leading to significant morbidity and large health care expenditures. Individualized high-dose, single-species allergen immunotherapy has been found to be effective in treating allergic rhinitis but can be associated with significant risks including anaphylaxis. Few studies have evaluated the safety and efficacy of universal low-dose multiallergen immunotherapy (MAIT). Objective: To determine the efficacy and safety of a universal MAIT formula for the treatment of allergic rhinitis. Methods: Patients with moderate-severe perennial and seasonal allergic rhinitis were randomized in a double-blind, placebo-controlled fashion to receive a novel, subcutaneous MAIT regimen containing a unique mixture of more than 150 aeroallergens, including several cross-reactive species. All patients received the exact same universal immunotherapy formula regardless of which specific skin tests were positive. Primary outcome measures at 8 and 12 weeks of therapy included validated clinical assessments, total nasal sinus score and mini-rhinoconjunctivitis quality of life questionnaire, and the use of rescue medications. Results: A total of 31 patients (n = 31) were randomized to receive MAIT vs placebo. By week 12, MAIT resulted in a -4.6 (-58%) decrease in the combined total nasal sinus score and rescue medication score (daily combined score) compared with -1.5 (-20%) for placebo (P = .04). Likewise, MAIT resulted in a decrease in the mini-rhinoconjunctivitis quality of life questionnaire score of -34.9 (-68%) compared with -17 (-42%) for the placebo (P = .04). Mild adverse events were uncommon and with similar frequency among the groups. Conclusion: A novel, universal, and high-species abundant MAIT formula was well tolerated and resulted in significant improvement in symptoms of moderate-severe allergic rhinitis. The results of this pilot study should be considered preliminary, pending further randomized clinical trials.
MeSH term(s)	Humans ; Pilot Projects ; Quality of Life ; Treatment Outcome ; Rhinitis, Allergic ; Desensitization, Immunologic/methods ; Double-Blind Method ; Conjunctivitis/etiology
Language	English
Publishing date	2023-03-28
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1228189-x
ISSN	1534-4436 ; 0003-4738 ; 1081-1206
ISSN (online)	1534-4436
ISSN	0003-4738 ; 1081-1206
DOI	10.1016/j.anai.2023.03.022
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Article: Rituximab-associated hypogammaglobulinemia in ANCA-associated vasculitis: Incidence and time course.

Tariq, Anam / Akenroye, Ayobami / Azar, Antoine / Seo, Philip / Geetha, Duvuru

European journal of rheumatology

2022 Volume 9, Issue 2, Page(s) 93–99

Abstract: Objective: Rituximab (RTX) is approved for remission induction and maintenance of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV). Observational studies demonstrate decline in immunoglobulin (IgG) in AAV post-RTX. The time ... ...

Abstract	Objective: Rituximab (RTX) is approved for remission induction and maintenance of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV). Observational studies demonstrate decline in immunoglobulin (IgG) in AAV post-RTX. The time course for the onset of hypogammaglobulinemia (Hypo-IgG) post-RTX is unknown. This is a key determinant in deciding whether to continue RTX for reinduction or maintenance of remission for AAV. We evaluated the trends of Hypo-IgG among AAV patients post-RTX therapies. Methods: An observational single-tertiary-center study of AAV patients treated with RTX for remission induction or maintenance (induction therapy, maintenance therapy, and combined induction and maintenance therapy) between 1998 and 2018. Poisson regression was used to compare the inciden- ces of Hypo-IgG: mild (450-700 mg dL-1), moderate (200-450 mg dL-1), and severe (􏰃200 mg dL-1). Ig levels were measured every 3-6 months after RTX use. Results: Mean (SD) age at last visit was 59 (16) years, 93% were Caucasians, 64% were females, and 71 (63%) had granulomatosis with polyangiitis (GPA). Hypo-IgG occurred in 47 patients: one (2%) severe, 13 (28%) moderate, and 33 (70%) mild. Lower incidences of mild Hypo-IgG post-RTX were seen during induction compared to maintenance (IR 5.04 per 100 000 days vs 5.45 per 100 000 days, incidence rate ratio (IRR) 1.08, 95% CI 0.34, 3.19). Moderate Hypo-IgG occurred at 2.29 per 100 000 days during induc- tion and 1.82 per 100 000 days during maintenance (IRR 0.79, 95% CI 0.08, 4.84). Conclusion: Hypo-IgG is common among AAV treated with RTX, occurring in 42% of patients in this single-center cohort. The nadir IgG levels occur during remission induction, and the IgG levels remain relatively stable or increase over time in those receiving RTX for remission maintenance.
Language	English
Publishing date	2022-02-14
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2873727-1
ISSN	2148-4279 ; 2147-9720
ISSN (online)	2148-4279
ISSN	2147-9720
DOI	10.5152/eujrheum.2022.20258
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Article: Isolated Bone Lesions in the Mandible and Maxilla of Langerhans Cell Histiocytosis Treated with Fractionated Stereotactic Low-Dose Radiotherapy: Case Report and 5-Year Follow-Up.

Berberi, Antoine / Aoun, Georges / Aad, Georges / Azar, Elie

Case reports in dentistry

2021 Volume 2021, Page(s) 9972240

Abstract: Langerhans cell histiocytosis is a benign histiocytic disorder touching both genders and can occur at any age. It is currently classified by the Histiocyte Society as an inflammatory myeloid neoplasm of mixed cellularity. Clinically, it is illustrated by ...

Abstract	Langerhans cell histiocytosis is a benign histiocytic disorder touching both genders and can occur at any age. It is currently classified by the Histiocyte Society as an inflammatory myeloid neoplasm of mixed cellularity. Clinically, it is illustrated by single or multiple osteolytic bone lesions associated with ulceration of the skin and soft tissues. Disease outcome is highly variable, depending on the degree of involvement. Bone pathologies are observed in 60% of cases as uni- or multifocal lesions. Several treatment modalities have been proposed and include surgical excision, intralesion steroid injection, chemotherapy, and low-dose radiotherapy. In this paper, we report a case of a 42-year-old male suffering from gingival swelling in the left side of his mandible and the right side of the maxilla. Clinical, radiological, and histological examinations confirm the diagnosis of Langerhans cell histiocytosis. Hematological investigation, entire body CT scan, and bone scintigraphy confirmed the limitation of the lesions in the right maxilla and on the left mandible. The lesions were treated with fractionated stereotactic low-dose radiotherapy, 24 Gy in 16 fractions, by using a linear accelerator with a custom-made rigid mask for accurate immobilization of the head with confirmed precision, which allows noninvasive approaches. Complete remission was achieved clinically and radiologically after one year, and a panoramic X-ray after 5 years confirms the bone healing process. Fractionated stereotactic low-dose RT could be adopted as an effective treatment.
Language	English
Publishing date	2021-08-03
Publishing country	Egypt
Document type	Case Reports
ZDB-ID	2627632-X
ISSN	2090-6455 ; 2090-6447
ISSN (online)	2090-6455
ISSN	2090-6447
DOI	10.1155/2021/9972240
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Article ; Online: Benralizumab effect on severe chronic rhinosinusitis with nasal polyps (CRSwNP): A randomized double-blind placebo-controlled trial.

Tversky, Jody / Lane, Andrew P / Azar, Antoine

Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology

2021 Volume 51, Issue 6, Page(s) 836–844

Abstract: Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) can be a severe and debilitating disease associated with significant morbidity, loss of smell, sinus pressure and asthma exacerbations. Eosinophils play a role in the majority (85%) of ... ...

Abstract	Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) can be a severe and debilitating disease associated with significant morbidity, loss of smell, sinus pressure and asthma exacerbations. Eosinophils play a role in the majority (85%) of patients. Benralizumab, an afucosylated monoclonal antibody directed against the IL-5 receptor, has powerful apoptotic effects on eosinophils. Objective: We sought to investigate the therapeutic benefit of inhibiting the IL-5 receptor using benralizumab to treat severe rhinosinusitis with nasal polyps. Methods: Patients with severe NP (defined by endoscopic grade 5 or more out of 8) with elevated eosinophils and a history of previous surgical or endoscopic polypectomy met entry criteria and were randomized in a double-blind fashion to receive 30 mg benralizumab SC or placebo. Endoscopic NP score was assessed at baseline and at treatment week 20. CT scan, SNOT-22 survey and UPSIT smell test score changes were also evaluated. Results: Thirty-three patients were screened, and twenty-four (n = 24) were enrolled in the study. Compared with baseline, benralizumab significantly improved NP score (-0.9 ± 0.2, P = 0.004) whereas placebo did not (-0.3 ± 0.3, P = 0.166). Benralizumab induced polyp size reduction compared with placebo did not reach statistical significance (P = 0.103). Five of 12 benralizumab-treated patients (42%) had improvements in all major outcomes (polyp score, CT, SNOT-22 and smell test) versus 2 out of 12 placebo (17%). The ratio of blood eosinophil count to allergen skin test positivity correlated with polyp reduction. Conclusion: Benralizumab was well-tolerated and compared with baseline achieved a statistically significant reduction in nasal polyp size, sinus occupancy, symptoms and improved sensation of smell for most patients (83%).
MeSH term(s)	Adult ; Anti-Asthmatic Agents/therapeutic use ; Antibodies, Monoclonal, Humanized/therapeutic use ; Chronic Disease ; Double-Blind Method ; Eosinophilia/immunology ; Eosinophils ; Female ; Humans ; Immunoglobulin E/immunology ; Leukocyte Count ; Male ; Middle Aged ; Nasal Polyps/drug therapy ; Nasal Polyps/immunology ; Rhinitis/drug therapy ; Rhinitis/immunology ; Severity of Illness Index ; Sinusitis/drug therapy ; Sinusitis/immunology ; Skin Tests ; Treatment Outcome
Chemical Substances	Anti-Asthmatic Agents ; Antibodies, Monoclonal, Humanized ; Immunoglobulin E (37341-29-0) ; benralizumab (71492GE1FX)
Language	English
Publishing date	2021-02-27
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	645204-8
ISSN	1365-2222 ; 0954-7894 ; 0960-2178
ISSN (online)	1365-2222
ISSN	0954-7894 ; 0960-2178
DOI	10.1111/cea.13852
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Article ; Online: Successful Desensitization to Febuxostat in a Patient With Hypersensitivity to Allopurinol and Febuxostat and Review of the Literature.

Koenig, Darya / Royer, Christine / Azar, Antoine

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases

2020 Volume 27, Issue 8S, Page(s) S432–S433

MeSH term(s)	Allopurinol/adverse effects ; Febuxostat/therapeutic use ; Gout/complications ; Gout/drug therapy ; Gout Suppressants/adverse effects ; Humans ; Hyperuricemia/drug therapy ; Treatment Outcome
Chemical Substances	Gout Suppressants ; Febuxostat (101V0R1N2E) ; Allopurinol (63CZ7GJN5I)
Language	English
Publishing date	2020-01-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1283266-2
ISSN	1536-7355 ; 1076-1608
ISSN (online)	1536-7355
ISSN	1076-1608
DOI	10.1097/RHU.0000000000001296
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